Citation: | TENG Yongshi, DAI Shuhua, LIU Huiqin, QIN Lingzhi, XUE Hongfei, XU Jiajia, Li Wei. Construction of a differential diagnosis model of ischemic stroke between moyamoya disease and non-moyamoya disease based on clinical data[J]. Journal of Clinical Medicine in Practice, 2023, 27(8): 1-6, 12. DOI: 10.7619/jcmp.20230332 |
To establish a differential diagnosis model between moyamoya disease (MMD) and non-MMD ischemic stroke by screening clinically accessible variables.
A total of 150 patients diagnosed with MMD ischemic stroke and 150 patients diagnosed with non-MMD ischemic stroke were included and divided into training group (210 cases) and validation group (90 cases) according to a ratio of 7 to 3. Logistic regression analysis, Lasso regression and support vector machine (SVM) were used to construct the diagnosis model; the optimal model was visualized with nomogram, and discriminant ability of the nomogram was tested in the training group and the validation group respectively.
Binary Logistic regression showed the largest C statistics in the training group and the verification group (0.87 and 0.88). Multivariate logistic regression analysis showed statistically significant differences (P < 0.05) in systolic blood pressure, total cholesterol (TC), albumin (ALB), free triiodothyranine (FT3), homocysteine (HCY) and age, and these six variables were included in the nomogram. Hosmer-Lemeshow test P values for the training group and the verification group were 0.28 and 0.19, respectively, and the calibration curve was well calibrated.The nomogram score < 168 was classified as a low risk of ischemic stroke in MMD, and the nomogram score ≥168 was classified as a high risk of ischemic stroke in MMD.
The nomograms established in the study can be used to distinguish MMD from non-MMD ischemic stroke, and it has been verified that the model has good discriminative ability in both training group and verification group.
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